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2015-04-14

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This video demonstrates the early surgical management of a 3-day history of acute cholecystitis in an 83-year-old patient. This patient was admitted to the emergency department for epigastric and right hypochondrium pain, without any other symptoms. Clinically, the patient presented with a localized abdominal guarding; Murphy’s sign was positive. Blood chemistries demonstrated the presence of an inflammatory syndrome and liver function tests were normal. The ultrasound exam confirmed the diagnosis of acute cholecystitis. A laparoscopic cholecystectomy was decided upon. The postoperative outcome was uneventful and the patient was discharged on postoperative day 3. Laparoscopic cholecystectomy is the gold standard for the early treatment of acute cholecystitis with an onset of symptoms less than 72 hours (Tokyo Guidelines 2013, recommendation 1, grade A).